The mission of the Northern New England Clinical and Translational Research Network (NNE-CTR) during the initial funding period has been to develop and sustain a clinical and translational research infrastructure that supports improvements in rural and community health in the IDeA states of Maine, New Hampshire and Vermont. The Administrative Core has developed the infrastructure to oversee the interactions of primary healthcare providers, clinical investigators, scientists, trainees, navigators, and community members to conduct clinical and translational research, with the goal of improving healthcare delivery, health outcomes, and population health in northern New England. The primary focus of the NNE-CTR is on health challenges affecting northern New Englanders and the barriers to prevention and treatment of chronic diseases and rural healthcare delivery. Three specific aims are proposed for this renewal application: 1) continue to oversee and develop the research infrastructure to support, maintain and grow clinical and translational investigation, with a priority on expanding clinical trials to reach rural areas of northern New England; 2) expand infrastructure to enhance collaborations with other CTRs and CTSIs for national initiatives; and 3) strengthen NNE-CTR support and expand leadership and collaboration with the Northern New England PBRN. The NNE-CTR will continue to build and sustain an infrastructure for clinical and translational scientists, leveraging the expertise of the two lead institutions and their partners. The NNE-CTR will provide the platform for enhancing clinical research and healthcare delivery and improving health outcomes for residents of northern New England.